UE PROSTHETICS Flashcards
two most common UE amputation causes
- trauma - MVA, machinery accidents, GSW, electrical burns
- disease - cancer, infection, PVD, diabetes
allergic to heparin
75% of UE amputations in adults are caused by ____
trauma
PROSTHETIC BUSINESS:
mostly LE, 5% UE
If you are a bilateral prosthetic user, they will use prosthetic more.
Is below elbow or above elbow more functional?
below elbow due to better positioning of terminal device
how to describe amputation levels of UE
shoulder disarticulation
transhumeral
elbow disarticulation
transradial
wrist disarticulation (WD)
transcarpal
finger amputation
If you lose which finger, then it is very difficult to function even with amputation prosthetic
thumb
wrist disarticulation: very long residual limb
what is beneficial about it? Why might it be better to have no prosthetic?
sensation still present, can compensate with residual limb!
*prosthetic used as tool, but usually people prefer sensation
transradial amputation is above or below elbow?
below elbow
What is a body powered arm/conventional arm?
terminal device is controlled by body but one movement at a time
what are types of UE prosthetics/choices for UE amputees
- no prosthesis
- passive functional/cosmetic
- body powered/conventional
- myoelectric/external power
- hybrid
- adaptive
different shoulder motions pull on a cable
electric powered UE prosthetic
contract mm, detected and joint will move
why do people with UE limb loss who COULD wear a prosthetic NOT want to wear one?
Bad First Experience (poor comfort or poorly
made)
Unnatural Look
Reactions from Others
Development of One-Handedness
Financial Concerns
Unaware of Options
Limited Functional Ability
Lack of Sufficient Prosthetic Training
What are advantages of passive functional/cosmetic UE prosthetics?
- Cosmetic
- Lightweight
- Simple
- Little Maintenance
- Inexpensive (NON-custom silicone)
- Great for Partial Hands
- Provides Opposition
what are disadvantages of UE passive functional/cosmetic prostheses?
- no active prehension
- limited function
- decreased durability
- unreal expectations for cosmesis
- custom silicone is expensive $$$
could play viola with passive functional-how?
squeeze with residual limb, opposition
body powered arms are controlled by
cable, harness system!
*GH flexion, scapular abduction, chest expansion, shoulder depression, extension, abd, flexion
*opens, closes terminal device!
advantages of body powered
- Heavy Duty Construction
- Proprioception
- Less Expensive
- Lighter in Weight
- Reduced Cost and Maintenance
Body powered UE device disadvantages
grip force is limited! (shoulder strength, rubber band tolerance)
-functional ROM/envelope is limited
-harness uncomfy, restrictive
-poor cosmesis
-POSSIBLE NERVE ENTRAPMENT, OVER USE
key points for harness systems
Suspension
Transferral of Body Motion & Forces to the Prosthesis
Typical Systems for Transradial Fittings
– single-control systems
Typical Systems for Transhumeral
Fittings
– double-control harness
– triple-control harness
single control harness: does what
double control harness: does what
single: operates terminal device
double: two control cables, can control another joint and the terminal device (like elbow joint)
voluntary opening: how do terminal devices work?
opens when the wearer
exerts tension on the control
cable which connects to the
“thumb” of the TD.
When
tension is released, rubber
bands or springs close the TD.
Pinch force is determined by
the number of rubber bands or
springs.
voluntary closing terminal device: how does it work?
start open, closes when wearer exerts tension on control cable, connecting to thumb of TD.
cable is relaxed TD
automatically opens by
spring operation. Pinch
force determined by
strength of wearer.
What is the myoelectric/external power controlled UE device?
powered by battery!
* myoelectric: electrodes from mm contraction
* switch: rocker, pull, push
* touch pads
advantages of myoelectric/ external power
- way stronger!
- greater functional envelope
- increased cosmesis
- greater grip force
- less/no harnessing system
